| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $215 | $272 | $330 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $166 | $276 | $335 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $67 | $119 | $251 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $98 | $136 | $163 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $259 | $259 | $259 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $94 | $126 | $156 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $169 | $245 | $322 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $127 | $241 | $390 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $95 | $214 | $434 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $86 | $181 | $276 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $160 | $333 | $506 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $599 | $599 | $599 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $167 | $304 | $650 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $337 | $337 | $337 |
| Avulsion of nail plate partial or complete CPT 11730 • Dermatology | $264 | $264 | $264 |
| Destruction premalignant lesion first lesion CPT 17000 • Dermatology | $72 | $135 | $198 |
| Destruction premalignant lesion 2-14 each additional CPT 17003 • Dermatology | $3 | $14 | $26 |
| Destruction premalignant lesion 15 or more CPT 17004 • Dermatology | $209 | $301 | $393 |
| Destruction benign lesions up to 14 CPT 17110 • Dermatology | $91 | $176 | $286 |
| Destruction benign lesions 15 or more CPT 17111 • Dermatology | $87 | $160 | $341 |
| Photochemotherapy tar and UV-B CPT 96910 • Dermatology | $107 | $136 | $165 |
| Laser treatment dermatologic up to 250 sq cm CPT 96920 • Dermatology | $147 | $260 | $372 |
| Blood glucose test strip HCPCS A4253 • Durable Medical Equipment | $5 | $28 | $50 |
| Calibration solution glucose monitor HCPCS A4256 • Durable Medical Equipment | $2 | $7 | $17 |
| Crutches forearm each HCPCS E0110 • Durable Medical Equipment | $50 | $83 | $131 |
| Walker folding wheeled adjustable height HCPCS E0143 • Durable Medical Equipment | $48 | $104 | $160 |
| Hospital bed semi-electric HCPCS E0260 • Durable Medical Equipment | $63 | $137 | $212 |
| Portable gaseous oxygen system HCPCS E0431 • Durable Medical Equipment | $27 | $96 | $165 |
| Nebulizer compressor HCPCS E0570 • Durable Medical Equipment | $16 | $43 | $70 |
| Oxygen concentrator portable HCPCS E1390 • Durable Medical Equipment | $85 | $123 | $160 |
| Negative pressure wound therapy electric pump HCPCS E2402 • Durable Medical Equipment | $2,589 | $5,030 | $7,472 |
| Standard wheelchair HCPCS K0001 • Durable Medical Equipment | $81 | $170 | $258 |
| Power wheelchair group 2 standard HCPCS K0823 • Durable Medical Equipment | $2,111 | $3,541 | $6,068 |
| Cervical collar nonadjustable HCPCS L0180 • Durable Medical Equipment | $224 | $260 | $296 |
| Lumbar support corset HCPCS L0650 • Durable Medical Equipment | $1,162 | $1,162 | $1,162 |
| Knee orthosis adjustable joint HCPCS L1832 • Durable Medical Equipment | $465 | $531 | $643 |
| Foot insert removable molded HCPCS L3000 • Durable Medical Equipment | $202 | $227 | $268 |
| Submucous resection inferior turbinate CPT 30140 • ENT | $277 | $658 | $1,417 |
| Septoplasty CPT 30520 • ENT | $635 | $1,330 | $2,024 |
| Ablation inferior turbinate unilateral intramural CPT 30801 • ENT | $729 | $729 | $729 |
| Nasal endoscopy diagnostic CPT 31231 • ENT | $173 | $193 | $213 |
| Nasal endoscopy with biopsy CPT 31237 • ENT | $239 | $536 | $833 |
| Nasal/sinus endoscopy with ethmoidectomy partial CPT 31254 • ENT | $409 | $655 | $900 |
| Nasal/sinus endoscopy with ethmoidectomy total CPT 31255 • ENT | $309 | $815 | $1,320 |
| Nasal/sinus endoscopy with maxillary antrostomy CPT 31256 • ENT | $35 | $241 | $651 |
| Nasal/sinus endoscopy with frontal sinus exploration CPT 31267 • ENT | $1,047 | $1,047 | $1,047 |
| Nasal/sinus endoscopy with sphenoidotomy CPT 31276 • ENT | $361 | $1,014 | $1,667 |
| Incision and drainage peritonsillar abscess CPT 42700 • ENT | $92 | $399 | $706 |
| Tonsillectomy and adenoidectomy under age 12 CPT 42820 • ENT | $280 | $684 | $1,089 |
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $1,131 | $1,131 | $1,131 |